Upfront surgery versus chemotherapy neoadjuvant in the survival of patients with locally advanced gastric signet-ring-cell adenocarcinoma. A scoping review

TL;DR

This study reviews whether starting with surgery or chemotherapy is better for a specific type of advanced stomach cancer.

Contribution

The study highlights the lack of evidence for neoadjuvant chemotherapy's effectiveness in signet-ring-cell gastric cancer.

Findings

Neoadjuvant chemotherapy does not show better survival outcomes than upfront surgery for locally advanced signet-ring-cell gastric adenocarcinoma.

Only five studies were found evaluating neoadjuvant chemotherapy versus surgery for this cancer type.

Clinical trials and national guidelines are needed to improve treatment evidence and management.

Abstract

Recent research suggests that neoadjuvant chemotherapy is not effective for gastric cancer with signet ring cells.

The present study performs a scoping review of research that seeks to determine whether neoadjuvant chemotherapy is more effective than upfront surgery in the survival of locally advanced signet ring gastric adenocarcinoma.

Online databases such as Pubmed, scopus and embase were used to identify articles from the last 20 years that used survival, as an initial or secondary outcome variable, after upfront surgery or neoadjuvant chemotherapy as initial treatment in locally advanced gastric signet ring cells adenocarcinoma.

After a systematic selection process, five primary studies were selected that evaluated neoadjuvant chemotherapy compared to primary surgery.

Neoadjuvant chemotherapy does not appear to have greater benefit than initial surgery in gastric adenocarcinoma with locally advanced sign ring cells, it is necessary to define which is the most appropriate qt scheme for adenocarcinoma with sign ring cells, clinical trials type studies are required to improve the evidence. Finally, a national clinical practice guide is required as an interpretative map for the management of gastric cancer which may be appropriate as a first step to know the reality.

Figures